A Tragic Situation in Indiana
The last four months have seen an unfortunate and unprecedented rise in HIV cases in Indiana. Officials say the twenty-seven confirmed cases, and ten additional preliminary cases, are largely due to IV painkiller abuse.
Since early December, painkiller addicts in the midwest have been sharing contaminated syringes. These dirty needles have, in turn, transmitted close to thirty confirmed cases of HIV. Some local officials believe unsafe sexual practices have also contributed to a number of cases.
The cause of this recent outbreak is Opana, a powerful opioid drug. Opana, which goes by the chemical name oxymorphone, is six to eight times stronger than morphine. That also makes it two to three times stronger than heroin. To say southern Indiana is in the midst of a twofold epidemic, drug abuse and HIV, is no stretch.
The counties hit the worst are all located in southeastern Indiana, on the border of Kentucky. Clark, Jackson, Perry, Scott, and Washington counties are the epicenter of this outbreak.
Dr. Jerome Adams, the State Health Commissioner, had the following to say about the increasing number of HIV cases and their link to IV pain pill abuse,
“Because prescription drug abuse is at the heart of this outbreak, we are not only working to identify, contact and test individuals who may have been exposed, but also to connect community members to resources for substance abuse treatment and recovery” (CBS Chicago).
Drug Related HIV
Dr. Adams is absolutely correct about Indiana’s HIV outbreak. It isn’t so much a matter of unsafe sexual practices, it’s more a matter of unsafe injection practices.
State officials have been quick to note that Opana itself isn’t inherently spreading HIV. The pill itself isn’t infected. Rather, Opana addicts sharing syringes are spreading the virus. Dr. Shane Avery believes a lack of education lies at the heart of Indiana’s outbreak.
He recently told the Indy Star, “It’s probably easier to get ahold of the Opana than it is the needles. This sounds almost unbelievable, but the issue is education… So many of them don’t appreciate or understand the dangers of sharing needles” (Indy Star).
What makes this particular cluster of HIV infections noteworthy is their link to prescription drugs rather than “traditional” drugs like heroin or cocaine. Users injecting Opana, or for that matter OxyContin and other opioid painkillers, are more likely to bleed and sustain open wounds for longer.
This is due, in no small part, to Opana manufactures making their drug “abuse-proof.” The unfortunate upshot of “abuse-proof” pain pills is that when shrewd addicts do figure out a way to abuse them, they’re putting themselves at risk. They’re injecting a dangerous combination of the drug itself, fillers, gel, and other abuse-deterrents.
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Another byproduct of abusing painkillers, and one that may have contributed to Indiana’s rise in HIV infections, is the perceived safety of prescription medication. Although heroin, cocaine, and meth have long been linked to HIV, painkillers haven’t.
Dr. Jan Scaglione, a clinical toxicologist at the Cincinnati Drug and Poison Information Center, said that IV Opana users might have been unaware of the need for clean syringes. The Indy Star reports,
“Heroin users have long been cautioned about the need to use clean needles. But those involved with this outbreak might not have been aware of the need — or thought they were safe because they were using a licensed pharmaceutical and knew those with whom they shared the needle” (Indy Star).
Indiana’s solution, which is still very much being implemented, is to educate those at risk. State health officials have begun to educate IV drug users about the importance of never reusing syringes and making sure syringes are properly sterilized before injecting drugs. State health officials have also begun to offer harm reduction services.
These measures should help tremendously to slow and hopefully stop Indiana’s HIV outbreak.